Monthly Regulatory & Industry Updates
Stay informed about important Pennsylvania home care industry developments, including DHS announcements, Medicaid and CHC updates, MCO provider notices, EVV requirements, and regulatory changes.
October 2026 – Medicaid, CHC & Regulatory Updates
October 22, 2026 – Pennsylvania Caregiver Payroll Compliance Update
Pennsylvania is increasing oversight of home care agency payroll practices through its Standing Up for Home Care Workers initiative. Agencies are encouraged to review caregiver wages, overtime calculations, travel time, and payroll records to ensure compliance with existing state wage and hour laws.
Official Resource: PA Standing Up for Home Care Workers – Payroll Compliance Initiative
Medicaid Provider Revalidation – Bulletin 99-26-06
The Pennsylvania Department of Human Services (DHS) has issued guidance regarding off-cycle Medicaid provider revalidation requirements for certain high-risk providers.
Home care agencies are encouraged to review their provider enrollment records, DHS correspondence, and PROMISe account information to determine whether these requirements apply to their agency.
Agency Reminder: Not all home care agencies are subject to this requirement. Providers should review the official bulletin and any individual notices received from DHS.
Official Resource: View DHS Medical Assistance Bulletins
October 2026 PROMISe Provider Updates
The Pennsylvania Department of Human Services (DHS) has published updated PROMISe claims and reference information, including billing error code descriptions and provider notices.
Home care agencies are encouraged to review these updates to determine whether any changes may affect their Medicaid billing, claims processing, or reimbursement procedures.
Agency Reminder: Agencies should regularly review DHS provider announcements to remain informed of applicable billing and program requirements.
Official DHS Resource: View October PROMISe Provider Updates
Pennsylvania Managed Care Quality Strategy – 2026
The Pennsylvania Department of Human Services (DHS) is updating its Medicaid and CHIP Managed Care Quality Strategy, which focuses on improving healthcare access, service quality, managed care performance, and accountability across Pennsylvania.
The announced public-comment period is October 17 – November 17, 2026.
Home care agency owners and administrators are encouraged to review the proposed strategy and consider submitting feedback on matters affecting Medicaid participants and service providers.
Agency Reminder: This is an opportunity for Pennsylvania home care providers to stay informed and participate in discussions that may influence future managed care policies.
Official DHS Resource: View Pennsylvania Managed Care Quality Strategy
Keystone First CHC – EVV & Program Integrity Updates
Keystone First Community HealthChoices (CHC) has issued provider communications addressing Electronic Visit Verification (EVV), program integrity, caregiver documentation, and service reporting requirements.
Home care agencies participating in Keystone First CHC are encouraged to review these notices to ensure their internal procedures remain consistent with applicable MCO requirements.
Agency Reminder: Agencies should pay particular attention to accurate EVV documentation, caregiver visit records, missed-shift reporting, and timely correction of identified discrepancies.
Official Keystone First CHC Resource: View Keystone First CHC Provider Communications
This information is provided for educational purposes. Providers should consult the applicable official notices to determine their individual compliance obligations.
Keystone First CHC – Participant Eligibility Verification
Keystone First Community HealthChoices (CHC) has reminded participating providers of the importance of verifying participant eligibility through Pennsylvania’s Eligibility Verification System (EVS).
Home care agencies should confirm participant eligibility and applicable coverage before providing services to help prevent billing discrepancies, claim denials, and reimbursement delays.
Agency Reminder: Agencies should not rely solely on previous authorizations or enrollment information. Participant eligibility should be verified for the applicable dates of service, and agencies should maintain appropriate verification records.
Official Keystone First CHC Resource: View Keystone First CHC Provider Communications
The Home Care Council of PA provides these updates for educational and informational purposes only. Agencies should consult official DHS, OLTL, and MCO communications to determine their individual compliance obligations.